No forcing flu vaccine on health workers

OTTAWA -- The Public Health Agency of Canada has no plan to deal with front-line health-care workers who refuse to be vaccinated against H1N1 flu, a scenario that some infectious-disease experts believe could accelerate the spread of the flu pandemic in the coming months.

The question of whether doctors and nurses should be forced to take flu vaccines has long been a contentious issue in the public-health community. In 2002, the Ontario government withdrew legislation that made it mandatory for paramedics to get flu shots, after the paramedics' union launched a legal challenge under the Charter of Rights and Freedoms.

The Canadian Medical Association, which represents tens of thousands of doctors nationwide, will introduce a resolution at its annual meeting next month that encourages physicians to get the swine-flu vaccine, which is expected to be ready in the fall. But the association will stop short of endorsing mandatory vaccinations, said CMA president Dr. Robert Ouellet.

"We think there should be informed consent," Ouellet said in an interview. "Everyone should have the right to refuse a vaccination if they think it's not right for them."

But some members of the medical community worry that such sensitivity toward the rights of health-care workers could undermine efforts to fight the flu pandemic.

It is believed roughly half of all front-line health-care workers take the seasonal flu shot every year -- a higher rate of uptake than in the general public, but enough to leave an alarming gap in the pandemic battle, some experts say.

"It's a human-rights issue," said Linda Silas, president of the Canadian Federation of Nurses Unions. "It's like any medication or vaccination. You cannot impose it on workers..."

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The first Canadian case of swine flu that is resistant to the antiviral drug Tamiflu raises a red flag but flu experts Wednesday were still far from pushing the panic button.

The resistant virus was found in a Quebec man, 60, who was given a preventive dose of the antiviral as a precaution because he had a pulmonary condition. His son fell sick with the virus.

But the father also became ill and researchers at a Quebec City laboratory on emerging viruses and antiviral resistance discovered he had a new strain of drug-resistant H1N1 virus.

It's believed the virus adapted to the drug and became resistant.

"It's one isolated case. We have to see what happens and if we do see more and more resistance coming up then that would be concerning," said Dr. Susy Hota, an infectious disease expert with the University Health Network in Toronto.

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